A large UK study has provided reassurance that taking hormone replacement therapy to relieve menopausal symptoms doesn鈥檛 increase the risk of dying early, and may even be slightly protective.
Hormone replacement therapy, or HRT, is used to relieve hot flushes, vaginal dryness, mood changes, sleep issues and other symptoms that many women experience as they approach menopause due to declining levels of the hormone oestrogen.
HRT works by replacing oestrogen, which can be administered using various methods, including patches, pills and gels. Unless an individual has had a hysterectomy, the hormone progesterone must be taken alongside oestrogen 鈥� known as combined HRT 鈥� because it protects the lining of the uterus.
Advertisement
鈥淗ormone therapy makes a huge difference,鈥� says at the Jean Hailes for Women鈥檚 Health Medical Centre in Australia, and past president of the . 鈥淲omen [who are prescribed it] walk back into my room and say, 鈥業 feel like me, I can function, I can cope, I can sleep鈥�.鈥�
In 2002, the popularity of HRT plummeted after it was reported that a study by the US Women鈥檚 Health Initiative had linked it with heart disease, stroke and breast cancer. But these reports were misleading because the study was done in older women 鈥� mostly over 60 鈥� who had already gone through menopause. They were trialling HRT to see if it improved heart health, not to fix menopause symptoms.
A large body of research now shows that HRT who take it to relieve menopause symptoms, and may even . It has also been shown to be .
On the other hand, there is some evidence that HRT can slightly increase the risk of and .
Because it is confusing to weigh up these potential risks and benefits, 聽at the University of East Anglia in the UK and her colleagues looked at the overall effect of HRT on the risk of dying from any cause.
To do this, they studied the anonymised electronic primary care records of more than 100,000 HRT users in the UK from 1984 to 2017. They compared each woman taking HRT with 1 to 3 similar-aged women attending the same general practice who had similar health characteristics at the baseline but didn鈥檛 take HRT.
They found that women taking oestrogen-only HRT didn鈥檛 have a greater risk of dying during the study period than non-users of HRT. Women taking combined HRT had a 9 per cent lower risk of dying during this time.
The finding is reassuring, says Davison, and reinforces advice from the and other expert bodies that the benefits of hormone therapy far outweigh the risks for healthy women who use it close to the time of menopause.
鈥淚t鈥檚 a balance,鈥� she says. 鈥淪ometimes the risks stack up because a woman might have a strong family history of breast cancer or a past history of a clot in her leg veins 鈥� a deep vein thrombosis 鈥� so we may not advise her to take hormone therapy. But for most women it鈥檚 safe.鈥�
BJOG
Sign up to our free Health Check newsletter for a round-up of all the health and fitness news you need to know, every Saturday
